Chondrocalcinosis Mimicking Rheumatoid Arthritis - A Case Series

Background: Chondrocalcinosis is due to deposition of calcium pyrophosphate dihydrate (CPPD) crystals in articular cartilage. The most affected joint is the knee. Few patients with CPPD may have an inflammatory arthritis which mimics rheumatoid arthritis. The aim of this paper was to identify the cases of CPPD presenting with recent onset symmetrical hand polyarthritis Materials and methods: Were reviewed the charts of patients from a tertiary rheumatologically referral center from the last five years in order to identify the cases of chondrocalcinosis mimicking rheumatoid arthritis onset. Results: Ten patients were identified with chondrocalcinosis presenting with symmetrical hand polyarthritis. Six patients were females; four patients were males, mean age was 71+/-2.1 years. All patients had recent onset of hands polyarthritis (35 +/- 5.28 days), three of them had also knee involvement and one patient shoulders involvement. Other causes of arthritis were excluded. All patients had normal erythrocyte sedimentation rate, C-reactive protein and were negative for rheumatoid factor, anti-citrullinated protein antibody. Patients were searched for secondary causes of chondrocalcinosis, but only one patient was diagnosed with hyperparathyroidism. Hands radiology showed in all patients calcification of triangular fibrocartilage in distal radioulnar joint and osteoarthritis. Treatment was with colchicine and nonsteroidal anti-inflammatory drugs. The patients were closely monitored in the following months for signs of rheumatoid arthritis or other inflammatory disease. Conclusions: Early onset of polyarthritis in elderly should raise the possibility of chondrocalcinosis.